The department of Obstetrics and Gynaecology sat down with Dr. Geoffrey Cundiff, the head of the department to learn about how he incorporates wellness in his daily life.
Why is wellness important to you and as department head, why is it an initiative that you’ve decided to prioritize?
Wellness is a personal priority for me. I have a lot of competing interests as a clinician, researcher, teacher and administrator. I take these on because I think they’re important, but some are more urgent than others and they all compete for a limited amount of time. This creates stress and I think it’s essential for people who take on these types of professional roles to have ways of decompressing so that that stress doesn’t have a negative affect on them.
I prioritize this for our department because I think that not only myself, but many of my colleagues face the same challenges with time management and stress. Often, these factors have a negative impact on one’s own enjoyment of life and second on their performance while on the job. This is increasingly well documented in the literature, and has gained recent recognition as an area that really needs attention. That’s why I prioritize it for the department, because I think wellness is critical to address in order to contribute to the sustainability of the department’s mandate.
Research suggests that OBGYN physicians face a great deal of burnout, as compared to other medical specialties. Why do you think that is?
Obstetricians spend more time in the hospital than probably any other specialty, and that is because they need to be immediately available for maternity care. In many healthcare organizations, OBGYNS have to do in house call. Most physicians have a responsibility to take call, but they don’t necessarily have to do it in the hospital. The need to be away from family separates us from our biggest emotional support. In addition, the nature of maternity care that occurs at all hours has a heavy toll on the sleep-wake cycle that impacts obstetricians more than many specialties.
One of the benefits of maternity care is the population for which we care that is generally healthy and experiencing a life defining experience. Sharing in that experience provides a lot of fulfillment for obstetricians, but maternity care is also the most litigious areas in medicine. This reality increases the stakes of medical decisions made by the OBGYN, which can be quite stressful.
Within our department, almost half of our department members work at multiple sites, and I think that is a multiplier for many of the burnout issues we talk about. For instance, physicians might have conflicting call schedules and travel concerns, which decreases their efficiency in planning and implementing their day.
What challenges does the department face in promoting wellbeing and what are the wellness successes that the department has achieved so far?
I think the biggest challenge is to capture the attention of our department members. They are busy people with a lot of conflicting responsibilities. It’s even harder to capture their attention in the long-term. I think that is our biggest challenge.
In spite this challenge, we have gotten individuals involved in our Faculty Wellness program. This includes Workshops on Resilience, and Mindfulness. We have also started A Leadership Development course that has been well received.
A second challenge in addressing wellness among the department is sustainability. While physician wellness is widely recognized as important within the health authority and the faculty of medicine, funding for wellness is lacking.
In summary, our first challenge is to capture OBGYNs attention and our second is to hold their attention, and our third is to fund the programs that will help them improve their wellness.
In terms of what we’ve done that is successful, I think that it’s too early to say what our biggest success is. I’m very excited about the UBC OBGYN mentoring and leadership programs. I am also very interested in The Rounds, and would like to see this virtual platform used more by our department members, as we have not captivated our physicians’ attention with that yet. I think the platform has a great deal of potential.
A significant part of making physician wellness sustainable is to create a community where we support each other, where we are able to recognize when people are in need of help, and where we have an opportunity to vent and communicate about challenges. A lot of the time, stressful issues are exacerbated when we ruminate on them. So the opportunity to discuss them allows us to decompress and helps resolve them. From travelling to multiple sites, having high demands on our time, as well as no longer having physical structures that create space for people to gather – these factors have compromised opportunities for communication and colleague interaction. The virtual physician lounge can help address these modern realities of healthcare.
What do you personally do to support your own wellbeing?
Every day, I engage in an exercise routine, which includes stretching, strengthening, and tai chi. I’ve stuck to this routine for thirty years. I also try to practice mindfulness, through meditation and by consciously grounding myself in the present.
One of the best things I’ve done to improve my wellbeing is to avoid driving, I’m not a terribly patient driver, so I am actually much happier when I’m biking or using transit. Also important for me are family dinners and regular interactions with friends.
When do you make time for these wellbeing initiatives?
I wake up early to do this routine before any of my daily responsibilities start. I spend an hour every day doing this, and because it’s the first thing I do, it’s my priority. I get exercise in transit, and I’ve incorporated that into my daily work-life so that it doesn’t get neglected.
What are one or two things that faculty members can do to foster a wellbeing environment within the department?
The most important thing that we can do at work to invest in wellbeing is to make sure that we focus the equivalent of a day a week on that aspect of our job that gives us the most satisfaction. For me, that is teaching surgery. After that, we can bring fulfillment to ourselves and colleagues by developing compassion for each other. When we pay attention to one another and try and observe and address when somebody looks down, we will help to foster an environment of wellbeing.